Tarsal-metatarsal joint procedure utilizing compressor-distractor and instrument providing sliding surface

Patent metadata

Field	Value
Publication number	US-2023218318-A1
Application number	US-202318186711-A
Country	US
Kind code	A1
Filing date	Mar 20, 2023
Priority date	Feb 13, 2019
Publication date	Jul 13, 2023
Grant date	—

Abstract

A surgical technique can involve inserting an instrument defining a sliding surface between a metatarsal and a laterally-adjacent metatarsal. The technique can include moving the metatarsal across the sliding surface of the instrument toward the cuneiform to close a space between the metatarsal and the opposed cuneiform.

First claim

1 . A method comprising:
preparing an end of a metatarsal; preparing an end of a cuneiform separated from the metatarsal by a tarsometatarsal joint; inserting an instrument defining a sliding surface between the metatarsal and a laterally-adjacent metatarsal; and compressing a prepared end of the metatarsal and a prepared end of the cuneiform together, wherein compressing the prepared end of the metatarsal and the prepared end of the cuneiform together comprises move the metatarsal across the sliding surface of the instrument toward the cuneiform.

2 . The method of claim 1 , wherein inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal comprises inserting the instrument defining the sliding surface between a proximal lateral end of the metatarsal and a medial side of the laterally-adjacent metatarsal.

3 . The method of claim 1 , wherein compressing the prepared end of the metatarsal and the prepared end of the cuneiform together comprises maintaining the instrument defining the sliding surface substantially stationary as the metatarsal is moved toward the cuneiform.

4 . The method of claim 1 , wherein compressing the prepared end of the metatarsal and the prepared end of the cuneiform together comprises moving the instrument defining the sliding surface with the metatarsal as the metatarsal is moved toward the cuneiform.

5 . The method of claim 1 , further comprising distracting the metatarsal from the cuneiform, wherein inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal comprises inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal while the metatarsal is distracted from the cuneiform.

6 . The method of claim 5 , further comprising cleaning a distracted space between the metatarsal and the cuneiform prior to inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal.

7 . The method of claim 1 , wherein:
preparing the end of the metatarsal comprises one or both of cutting and fenestrating the end of the metatarsal; and preparing the end of the cuneiform comprises one or both of cutting and fenestrating the end of the cuneiform.

8 . The method of claim 1 , wherein:
preparing the end of the metatarsal comprises cutting the end of the metatarsal; and preparing the end of the cuneiform comprises cutting the end of the cuneiform.

9 . The method of claim 8 , wherein:
cutting the end of the metatarsal comprises cutting the end of the metatarsal using a bone preparation guide to guide a cutting instrument to cut the end of the metatarsal; and cutting the end of the cuneiform comprises using the bone preparation guide to guide the cutting instrument to cut the end of the cuneiform.

10 . The method of claim 1 , wherein inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal comprises inserting the instrument after preparing the end of the metatarsal and after preparing the end of the cuneiform.

11 . The method of claim 1 , further comprising:
moving the metatarsal in one or both of a transverse plane and a frontal plane to correct a bunion; and fixating a moved position of the metatarsal relative to the cuneiform by inserting at least one fixation device across the tarsometatarsal joint.

12 . The method of claim 11 , wherein moving the metatarsal in one or both of the transverse plane and the frontal plane comprises moving the metatarsal in the transverse plane to close an intermetatarsal angle between the metatarsal and the laterally-adjacent metatarsal.

13 . The method of claim 1 , further comprising attaching a compressor-distractor to the metatarsal and the cuneiform, wherein compressing the prepared end of the metatarsal and the prepared end of the cuneiform together comprises actuating the compressor-distractor.

14 . The method of claim 1 , wherein:
the instrument has a length extending from a leading end to a trailing end and tapers in thickness along at least a portion of the length from the trailing end to the leading end; and the instrument has a generally rectangular cross-sectional shape.

15 . The method of claim 1 , wherein:
the metatarsal is a first metatarsal; the cuneiform is a medial cuneiform; and the laterally-adjacent metatarsal is a second metatarsal.

16 . A method comprising:
distracting a metatarsal from an opposed cuneiform to open a space between the metatarsal and the opposed cuneiform; inserting an instrument defining a sliding surface between the metatarsal and a laterally-adjacent metatarsal; and moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform to close the space between the metatarsal and the opposed cuneiform.

17 . The method of claim 16 , wherein inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal comprises inserting the instrument defining the sliding surface between a proximal lateral end of the metatarsal and a medial side of the laterally-adjacent metatarsal.

18 . The method of claim 16 , wherein moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform comprises maintaining the instrument defining the sliding surface substantially stationary as the metatarsal is moved toward the opposed cuneiform.

19 . The method of claim 16 , wherein moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform comprises moving the instrument defining the sliding surface with the metatarsal as the metatarsal is moved toward the opposed cuneiform.

20 . The method of claim 16 , further comprising, prior to moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform:
preparing an end of the metatarsal; and preparing an end of the opposed cuneiform.

21 . The method of claim 20 , further comprising:
moving the metatarsal in one or both of a transverse plane and a frontal plane to correct a bunion; and fixating a moved position of the metatarsal relative to the opposed cuneiform by inserting at least one fixation device across a tarsometatarsal joint separating the metatarsal from the opposed cuneiform.

22 . The method of claim 16 , further comprising attaching a compressor-distractor to the metatarsal and the opposed cuneiform, wherein moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform comprises actuating the compressor-distractor.

23 . The method of claim 16 , wherein moving the metatarsal across the sliding surface of the instrument toward the opposed cuneiform comprises moving the metatarsal axially toward the opposed cuneiform.

24 . The method of claim 23 , wherein inserting the instrument defining the sliding surface between the metatarsal and the laterally-adjacent metatarsal comprises inserting the instrument between the metatarsal and obstructing matter frictionally interfering with axial movement of the metatarsal toward the opposed cuneiform.

25 . The method of claim 16 , wherein:
the metatarsal is a first metatarsal; the opposed cuneiform is a medial cuneiform; and the laterally-adjacent metatarsal is a second metatarsal.

Assignees

• Treace Medical Concepts Inc

Inventors

• Treace John T
• Ferguson Joe W
• Gil Carlos Eduardo
• Scanlan Sean F

Classifications

• A61B17/66 Primary

  {Alignment}, compression or distraction mechanisms · CPC title

• A61B17/56 Primary

  Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor · CPC title

• A61B17/8866

  for gripping or pushing bones, e.g. approximators (joint distractors A61B17/025) · CPC title

• A61B2017/565

  for surgical correction of axial deviation, e.g. hallux valgus or genu valgus · CPC title

• A61B17/151

  for corrective osteotomy · CPC title